If you grew up in the ’90s, you know West Coast and East Coast rap sounded similar but hit differently. Your mom couldn’t tell them apart and she hated both.
Same goes for home care vs. home health care. They sound alike, but they’re not the same.
Feeling Hypnotized trying to figure it out for Dad? Keep Ya Head Up — we’re breaking it down below.
ICYMI (in case you missed it)
🎤 Country music’s queen, Dolly Parton, is 80 and is just getting started.
🏥 A nurses strike in New York City is affecting both patients and caregivers alike.
💼 Employers are being urged to better support workers caring for kids or aging parents, including flexible schedules, clearer benefits, and paid leave.
🏡 A recent poll the American Customer Satisfaction Index conducted looked at how families are navigating the family care landscape. 11% of respondents named Gray Monster as the most helpful resource.
What Do You Mean It’s Not Covered?
This isn’t a diss track, more of a heads-up before Dad gets discharged. Figuring out in-home care shouldn’t be a mystery, but if you don’t know the difference, it’ll cost you more than replacing the CDs your mom “accidentally” trashed in high school.
Here’s the scoop:
Home Care: Non-medical help at home that’s personal assistance with activities of daily living (ADLs) including bathing, meals, dressing and supervision (aka “custodial” care).
Home Health Care: Medical, skilled care at home like nursing/therapy visits ordered by a doctor after illness/injury/surgery/hospitalization.
Home Care vs Home Health Care
Home Care (Custodial) | Home Health Care (Skilled) | |
|---|---|---|
Who provides it | Caregiver/aide | Nurse + PT/OT/ST (sometimes aide as part of plan) |
Typical tasks | Bathing, meals, errands, light housework, companionship, reminders | Wound care, injections, vitals, rehab therapy, med management |
How you qualify | Dad needs help with daily life | Doctor order + Dad meets skilled criteria (often “homebound”) |
How long it lasts | Can be ongoing | Usually short-term/intermittent (weeks, not forever) |
Who pays (most common) | Mostly out-of-pocket; sometimes Medicaid/LTC insurance | Often Medicare/Medicare Advantage if approved and eligible |
Gotchas | “All-day help” usually not covered by Medicare | Not 24/7 — visits can be 2–3x/week |
What Covers What
Medicare (Original aka Part A and Part B)
Usually covers skilled home health care (nursing and/or therapy) when medically necessary and ordered. Usually doesn’t include ongoing custodial care (bathing, meals, supervision) or 24/7 help.
Medicare Advantage
Medicare through a private plan. Rules vary. Expect in-network requirements and prior authorization. Some plans offer limited extra in-home benefits — you have to ask.
Medicaid
State-run. Assuming Dad qualifies, it’s often the most affordable option for ongoing home care delivered through home/community programs (varies by state, eligibility, and waitlists). Strict income and asset limits apply, and patience with paperwork is required.
What this looks like in real-life:
Dad needs help with bathing and meals after a fall usually means home care (often not covered by Medicare). You’ve got to find, vet, hire and pay out of pocket.
Dad is back home and needs wound care and/or PT after surgery. This usually means home health care (often covered by Medicare/Medicare Advantage if criteria is met).
Dementia and it’s unsafe for Dad to be left alone. This usually requires home care/supervision via Medicaid/LTC insurance more likely; rules vary or you can private pay but it likely won’t be cheap.
Talking to a hospital discharge team or an agency? Ask the following:
“Does Dad need skilled home health care or home care?”
“What are the qualifying criteria and what documentation do you need?”
“How many visits/hours are approved and for how long?”
“Do you require prior authorization?”
“Is the agency you’re referring my dad to in-network?”
“How do you get paid?”
Want to know what other resources Dad may be eligible for? Our homies at the National Council on Aging have an online tool to help you figure it out.
What’s Good
Helpful care-focused finds we’ve identified and researched so you don’t have to.
Eldercare Locator for support finding local help. Run by the Administration for Community Living out of the U.S. Department for Health and Human Services, it’s a simple starting point for older adults or anyone caring for one.
With one search by zip code, you can find local services like meals, transportation, caregiver support, respite care, and legal help. Resources are available online, via chat, and phone.
Parenting Parents
You said it. This week’s submissions.
“Dad is gone, but no regrets despite it being the hardest thing I've ever done.”
“Dad falls asleep during wound appointments and snore like a cartoon character.”
“On her birthday, Mom kept insisting it was my birthday and my special day.”
“My parents aren't in need of caregiving yet, but I've sensed a shift in their outlook.”
“Ever since Mom passed, Dad has these "girlfriends" he keeps talking about.”
